Pathology Trends
Pathology groups face a number of challenging pathology trends in the era of radical healthcare reform.
One of the primary trends is that like clinical laboratories, these businesses are carrying significant and potentially unsustainable levels of unreimbursed services. Although bad debt and uncompensated care in the healthcare industry are not new, they have been increasing at the same time that downward pressure is being applied to pathology reimbursement.
Medical laboratories and pathology groups are also facing enormous levels of change in their clinical, regulatory and financial environments. As the Affordable Care Act is implemented, laboratories see downward pressure on reimbursement at both the federal and payer level, coupled with increased emphasis on efficiency and quality.
Labs and health care providers need to seriously consider moving toward a retail business model. Changes in the health insurance market are now requiring patients to pay more out of pocket, and the perfect storm of bad debt and decreased requirement is pressuring laboratories.
Other pathology trends include:
- Growing emphasis on the continuum of care
- Increasing patient interaction directly with the lab organization
- Mounting demands of interoperability across a proliferation of disparate information technology systems to achieve meaningful use
- Evolving requirements for communication and data sharing with payers, accountable care organizations (ACOs), health information exchanges (HIEs) and other trading partners
Industry observers say that responding to each of these trends requires access to the most complete set of patient data possible. Accurate patient identification and record consolidation is central to achieving these goals.
In addition, labs and pathologists are increasingly urged to add value to the testing services they perform by leveraging information technology. For instance, advanced health information technology can be deployed within clinical labs and pathology groups specifically to meet changing patient expectations, while supporting the needs of client physicians for optimal workflow.
Record 600 Pathologist Jobs Open Nationwide
CEO SUMMARY: Demand for top-level pathologists is surging. A strong rise in the number of job openings for pathologists results from a combination of factors, some related to COVID-19. Now that physicians are seeing patients again, the number of specimens has risen after falling las…
Many Patients in United Kingdom Not Getting Speedy Diagnosis
RECENT NEWS REPORTS IN THE UNITED KINGDOM indicate that the COVID-19 pandemic has exacerbated the ongoing problem of lengthy delays in diagnosis of patients within the National Health Service (NHS). This is particularly true of delays for patients waiting on results of their cancer tests….
$400,000 Settlement in VA Wrongful-Death Case
CEO SUMMARY: Did “the system” fail patients and physicians at one Veterans Health Administration center? The public disciplinary records of pathologist Robert Morris Levy over several decades show that any laboratory employing Levy had reason to monitor closely the accuracy of h…
Details Emerge in KU Hospital Misdiagnosis by Pathology Chair
AFTER A PATIENT FILED A LAWSUIT against a pathologist at the University of Kansas Hospital for fraud and negligence in a case stemming from a misdiagnosis of cancer in 2015, details about a settlement in the case were sealed. Now, some details have come out. Last month, NPR statio…
Anthem’s Cuts in AP Fees Could Put Patients at Risk
CEO SUMMARY: Consultants who work with anatomic pathologists have several theories about why Anthem is enacting deep cuts of 50% to 70% for the professional component of many anatomic pathology services. While they have different ideas about what motivates the nation’s second largest he…
Few Options for Pathology Groups Facing Anthem’s Payment Cuts
FACED WITH DEEP CUTS in payment for anatomic pathology professional component services from Anthem Inc., pathologist have only a few options in how they can respond, according to consultants who work with AP groups. “These are dire cuts to anatomic pathology reimbursement,” said…
Arkansas Pathologist Faces 3 Manslaughter Charges
CEO SUMMARY: Federal prosecutors in Arkansas charged a former Veterans Administration pathologist with three counts of involuntary manslaughter and 28 other criminal counts related to his work at the Veterans Health Care System of the Ozarks. In the indictment, officials charged that the …
Is Pathology Workforce Stable or Shrinking?
CEO SUMMARY: After publishing research in JAMA Network Open showing a coming shortage of pathologists in the United States, the researchers heard from pathologists whose experience in the job market did not match what the researchers found. Anecdotal evidence indicates that the demand for…
JAMA Study: 17% Fewer Pathologists Since 2007
CEO SUMMARY: The number of pathologists working in the United States declined by 17.53% from 2007 to 2017, according to recent research published in the Journal of the American Medical Association. When adjusted for the U.S. population, the researchers said the workforce of pathologists i…
Fewer Pathologists Means Tighter Market for Jobs
CEO SUMMARY: Pathologists seeking jobs will find that a more competitive job market is pushing salaries up over $300,000 per year on average. In addition, most new jobs come with a hiring bonus and funds for relocation of as much as $12,000 and for continuing medical education of $3,500. …
CURRENT ISSUE
Volume XXVIII, No. 14 – October 18, 2021
The former Theranos lab director, pathologist Adam Rosendorff MD, has been in the news, as Elizabeth Holmes’ defense demonstrates the risks associated with lab oversight. Also, Walgreens has announced it will build 1,000 primary care clinics by 2027, showing how the traditional model of primary care is changing.
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